Thromboelastography‐Guided Blood Product Use Before Invasive Procedures in Cirrhosis With Severe Coagulopathy: A Randomized Controlled Trial

Olson, Jody C.

doi:10.1002/cld.749

Cited by 9 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, pathological findings do not translate into bleeding risk or the need for coagulation factors [74][75][76]. Viscoelastic tests may be superior in evaluating clot formation ability in patients with liver disease [77,78]. Coagulation therapy should be considered for patients at high risk of bleeding, with a scheduled invasive procedure or for patients actively bleeding [79,80].…”

Section: Liver Diseasementioning

confidence: 99%

Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding

Neuenfeldt

Weigand

Fischer

2021

JCM

View full text Add to dashboard Cite

Patient Blood Management advocates an individualized treatment approach, tailored to each patient’s needs, in order to reduce unnecessary exposure to allogeneic blood products. The optimization of hemostasis and minimization of blood loss is of high importance when it comes to critical care patients, as coagulopathies are a common phenomenon among them and may significantly impact morbidity and mortality. Treating coagulopathies is complex as thrombotic and hemorrhagic conditions may coexist and the medications at hand to modulate hemostasis can be powerful. The cornerstones of coagulation management are an appropriate patient evaluation, including the individual risk of bleeding weighed against the risk of thrombosis, a proper diagnostic work-up of the coagulopathy’s etiology, treatment with targeted therapies, and transfusion of blood product components when clinically indicated in a goal-directed manner. In this article, we will outline various reasons for coagulopathy in critical care patients to highlight the aspects that need special consideration. The treatment options outlined in this article include anticoagulation, anticoagulant reversal, clotting factor concentrates, antifibrinolytic agents, desmopressin, fresh frozen plasma, and platelets. This article outlines concepts with the aim of the minimization of complications associated with coagulopathies in critically ill patients. Hereditary coagulopathies will be omitted in this review.

show abstract

Section: Liver Diseasementioning

confidence: 99%

Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding

Neuenfeldt

Weigand

Fischer

2021

JCM

View full text Add to dashboard Cite

show abstract

“…The lack of the R time extension prompt factor can be corrected by fresh frozen plasma (FFP). 21 When the R time value is greater than 10 min, the patient will be infused with 2 U of FFP; when the R time value is greater than 15 min, the patient will be infused with 4 U of plasma; when the R time value is greater than 20 min, the patient will be infused with 6 U. 22 Angle α is the measurement of fibrin cross linkage mechanics or clot strengthening speed.…”

Section: Intraoperative Interventionmentioning

confidence: 99%

“…Low MA may be corrected by the administration of PLTs. 21 At MA<45, PLT transfusion will begin. LY30 values show the rate of thrombus rupture at 30 min after MA.…”

Section: Intraoperative Interventionmentioning

confidence: 99%

Thromboelastography-guided blood transfusion during cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: study protocol for a prospective randomised controlled trial

et al. 2020

View full text Add to dashboard Cite

IntroductionCytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a well-established treatment for peritoneal cancer (PC). However, this kind of combination therapy is associated with a high incidence of complications. Moreover, relative studies have indicated that traditional laboratory testing is insufficient to demonstrate the overall haemostatic physiology of CRS/HIPEC. Thromboelastography (TEG), administered by monitoring dynamic changes in haemostasis, has been shown to contribute to reducing transfusion requirements and improving survival. However, there is no evidence to verify whether TEG can be applied to guide transfusion strategies during CRS/HIPEC. Therefore, we aim to investigate whether TEG-guided blood product transfusion (TEG-BT) therapy is superior to traditional blood product transfusion (T-BT) therapy for guiding perioperative blood transfusion treatment and improving the prognosis of patients undergoing CRS/HIPEC.Methods and analysisThe TEG-BT versus T-BT study is a single-centre, randomised, blinded outcome assessment clinical trial of 162 patients with PC, aged 18–64 years and undergoing CRS/HIPEC. Participants will be randomly allocated to receive TEG-BT or T-BT. The primary outcome will be the evaluation of perioperative blood transfusion, which refers to the total amount of blood transfusion given from the time patients enter the operating room up to 72 hours postoperatively. The secondary outcomes will include the transfusion volume during surgery, total amount of intraoperative infusion, amount of blood lost during the operation, total blood transfusion between 0 and 72 hours after surgery, lowest haemoglobin level within 72 hours after surgery, intensive care unit duration, overall length of stay, total cost of hospitalisation and adverse events. Data will be analysed according to the intention-to-treat principle.Ethics and disseminationThe study protocol has been approved by the Scientific Research Ethics Committee of Beijing Shijitan Hospital Affiliated with Capital Medical University (Approval Number: sjtkyll-lx-2020-3). The results will be published in peer-reviewed journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000028835).

show abstract

“…4 Consequently, investigation and clinical use of VETs are expanding with aims of broader clinical applications. [4][5][6] HOw is iT PerFOrMeD?…”

mentioning

confidence: 99%

“…Given the broadly accepted shift in our understanding of hemostasis as “rebalanced” in liver disease, VETs (TEG and rotational thromboelastometry [ROTEM]) offer attractive features to both investigators and clinicians alike 4 . Consequently, investigation and clinical use of VETs are expanding with aims of broader clinical applications 4‐6 …”

mentioning

confidence: 99%

Thromboelastography and Utility in Hepatology Practice

Shenoy

Intagliata

2020

Clin. Liver Dis.

View full text Add to dashboard Cite

show abstract

Thromboelastography‐Guided Blood Product Use Before Invasive Procedures in Cirrhosis With Severe Coagulopathy: A Randomized Controlled Trial

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/13-4-reading-olson a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/13-4-interview-olson the interview with the author

Cited by 9 publications

References 11 publications

Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding

Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding

Thromboelastography-guided blood transfusion during cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: study protocol for a prospective randomised controlled trial

Thromboelastography and Utility in Hepatology Practice

Contact Info

Product

Resources

About